Health is not just about what happens at the doctor’s office. All health outcomes, from birth weight to blood pressure, are impacted by what are called structural determinants of health (SDoH). These are factors like income level, housing, food access, immigration status, race, ethnicity, sexual orientation and gender identity.

Structural determinants of health are the reason why the infant mortality rate among African Americans is more than twice as high as the infant mortality rate for white Americans. Because of this country’s history of racism, race actually determines health outcomes. Structural determinants are also the reason why communities without access to healthy, affordable food are more likely to suffer from diabetes, high blood pressure, or heart disease. Geography and food access can determine health.